Outcomes in patients requiring cardioversion following catheter ablation of atrial fibrillation

Karuna Chilukuri, Jonathan Dukes, Darshan Dalal, Joseph E. Marine, Charles Henrikson, Daniel Scherr, Sunil Sinha, Ronald Berger, Alan Cheng, Saman Nazarian, David Spragg, Hugh Calkins

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Introduction: Early recurrence of atrial tachyarrhythmias is commonly noted after catheter ablation of atrial fibrillation (AF). The long-term outcomes of patients who require cardioversion for persistent AF after AF ablation is not known. This study reports the outcomes of patients who underwent cardioversion for persistent AF or atrial flutter following an AF ablation procedure. Methods: The patient population comprised 55 patients (mean age 58 ± 10 years, 35% paroxysmal) who underwent catheter ablation of AF and subsequently required electrical cardioversion for persistent AF (45 patients) or atrial flutter (10 patients). Cardioversion was defined as early (within 90 days of the ablation procedure) or late (between 90 and 180 days following ablation). Results: The mean follow-up duration was 15 ± 8 months. Forty-six of the 55 patients (84%) patients experienced recurrence during follow-up. The average time to recurrence after cardioversion was 37 days. Of the 55 patients, 8 (15%) patients had a complete success, 11 (20%) patients had a partial success and 36 patients (65%) had a failed outcome. Seven of the 43 patients (16%) who underwent early cardioversion had a complete success as opposed to one of 12 patients (8%) who underwent late cardioversion (P = 0.49). Conclusions: This study shows that >80% of patients who undergo cardioversion for persistent AF or atrial flutter after AF ablation have recurrence. The timing of cardioversion did not affect the outcome. These findings allow clinicians to provide realistic expectations to patients regarding the long-term outcome and/or requirement for a second ablation procedure.

Original languageEnglish (US)
Pages (from-to)27-32
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume21
Issue number1
DOIs
StatePublished - 2010
Externally publishedYes

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Electric Countershock
Catheter Ablation
Atrial Fibrillation
Atrial Flutter
Recurrence

Keywords

  • Atrial fibrillation
  • Atrial flutter
  • Cardioversion
  • Catheter ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Outcomes in patients requiring cardioversion following catheter ablation of atrial fibrillation. / Chilukuri, Karuna; Dukes, Jonathan; Dalal, Darshan; Marine, Joseph E.; Henrikson, Charles; Scherr, Daniel; Sinha, Sunil; Berger, Ronald; Cheng, Alan; Nazarian, Saman; Spragg, David; Calkins, Hugh.

In: Journal of Cardiovascular Electrophysiology, Vol. 21, No. 1, 2010, p. 27-32.

Research output: Contribution to journalArticle

Chilukuri, K, Dukes, J, Dalal, D, Marine, JE, Henrikson, C, Scherr, D, Sinha, S, Berger, R, Cheng, A, Nazarian, S, Spragg, D & Calkins, H 2010, 'Outcomes in patients requiring cardioversion following catheter ablation of atrial fibrillation', Journal of Cardiovascular Electrophysiology, vol. 21, no. 1, pp. 27-32. https://doi.org/10.1111/j.1540-8167.2009.01593.x
Chilukuri, Karuna ; Dukes, Jonathan ; Dalal, Darshan ; Marine, Joseph E. ; Henrikson, Charles ; Scherr, Daniel ; Sinha, Sunil ; Berger, Ronald ; Cheng, Alan ; Nazarian, Saman ; Spragg, David ; Calkins, Hugh. / Outcomes in patients requiring cardioversion following catheter ablation of atrial fibrillation. In: Journal of Cardiovascular Electrophysiology. 2010 ; Vol. 21, No. 1. pp. 27-32.
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abstract = "Introduction: Early recurrence of atrial tachyarrhythmias is commonly noted after catheter ablation of atrial fibrillation (AF). The long-term outcomes of patients who require cardioversion for persistent AF after AF ablation is not known. This study reports the outcomes of patients who underwent cardioversion for persistent AF or atrial flutter following an AF ablation procedure. Methods: The patient population comprised 55 patients (mean age 58 ± 10 years, 35{\%} paroxysmal) who underwent catheter ablation of AF and subsequently required electrical cardioversion for persistent AF (45 patients) or atrial flutter (10 patients). Cardioversion was defined as early (within 90 days of the ablation procedure) or late (between 90 and 180 days following ablation). Results: The mean follow-up duration was 15 ± 8 months. Forty-six of the 55 patients (84{\%}) patients experienced recurrence during follow-up. The average time to recurrence after cardioversion was 37 days. Of the 55 patients, 8 (15{\%}) patients had a complete success, 11 (20{\%}) patients had a partial success and 36 patients (65{\%}) had a failed outcome. Seven of the 43 patients (16{\%}) who underwent early cardioversion had a complete success as opposed to one of 12 patients (8{\%}) who underwent late cardioversion (P = 0.49). Conclusions: This study shows that >80{\%} of patients who undergo cardioversion for persistent AF or atrial flutter after AF ablation have recurrence. The timing of cardioversion did not affect the outcome. These findings allow clinicians to provide realistic expectations to patients regarding the long-term outcome and/or requirement for a second ablation procedure.",
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AU - Chilukuri, Karuna

AU - Dukes, Jonathan

AU - Dalal, Darshan

AU - Marine, Joseph E.

AU - Henrikson, Charles

AU - Scherr, Daniel

AU - Sinha, Sunil

AU - Berger, Ronald

AU - Cheng, Alan

AU - Nazarian, Saman

AU - Spragg, David

AU - Calkins, Hugh

PY - 2010

Y1 - 2010

N2 - Introduction: Early recurrence of atrial tachyarrhythmias is commonly noted after catheter ablation of atrial fibrillation (AF). The long-term outcomes of patients who require cardioversion for persistent AF after AF ablation is not known. This study reports the outcomes of patients who underwent cardioversion for persistent AF or atrial flutter following an AF ablation procedure. Methods: The patient population comprised 55 patients (mean age 58 ± 10 years, 35% paroxysmal) who underwent catheter ablation of AF and subsequently required electrical cardioversion for persistent AF (45 patients) or atrial flutter (10 patients). Cardioversion was defined as early (within 90 days of the ablation procedure) or late (between 90 and 180 days following ablation). Results: The mean follow-up duration was 15 ± 8 months. Forty-six of the 55 patients (84%) patients experienced recurrence during follow-up. The average time to recurrence after cardioversion was 37 days. Of the 55 patients, 8 (15%) patients had a complete success, 11 (20%) patients had a partial success and 36 patients (65%) had a failed outcome. Seven of the 43 patients (16%) who underwent early cardioversion had a complete success as opposed to one of 12 patients (8%) who underwent late cardioversion (P = 0.49). Conclusions: This study shows that >80% of patients who undergo cardioversion for persistent AF or atrial flutter after AF ablation have recurrence. The timing of cardioversion did not affect the outcome. These findings allow clinicians to provide realistic expectations to patients regarding the long-term outcome and/or requirement for a second ablation procedure.

AB - Introduction: Early recurrence of atrial tachyarrhythmias is commonly noted after catheter ablation of atrial fibrillation (AF). The long-term outcomes of patients who require cardioversion for persistent AF after AF ablation is not known. This study reports the outcomes of patients who underwent cardioversion for persistent AF or atrial flutter following an AF ablation procedure. Methods: The patient population comprised 55 patients (mean age 58 ± 10 years, 35% paroxysmal) who underwent catheter ablation of AF and subsequently required electrical cardioversion for persistent AF (45 patients) or atrial flutter (10 patients). Cardioversion was defined as early (within 90 days of the ablation procedure) or late (between 90 and 180 days following ablation). Results: The mean follow-up duration was 15 ± 8 months. Forty-six of the 55 patients (84%) patients experienced recurrence during follow-up. The average time to recurrence after cardioversion was 37 days. Of the 55 patients, 8 (15%) patients had a complete success, 11 (20%) patients had a partial success and 36 patients (65%) had a failed outcome. Seven of the 43 patients (16%) who underwent early cardioversion had a complete success as opposed to one of 12 patients (8%) who underwent late cardioversion (P = 0.49). Conclusions: This study shows that >80% of patients who undergo cardioversion for persistent AF or atrial flutter after AF ablation have recurrence. The timing of cardioversion did not affect the outcome. These findings allow clinicians to provide realistic expectations to patients regarding the long-term outcome and/or requirement for a second ablation procedure.

KW - Atrial fibrillation

KW - Atrial flutter

KW - Cardioversion

KW - Catheter ablation

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